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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SPENCER MOORE
NPI 1114729340
Student in an Organized Health Care Education/Training Program in Indianapolis, IN

Active since March 26, 2025PECOS Enrolled
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202(317) 338-6399(317) 338-6359 Get Directions Write a Review

NPPES record last updated: June 16, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Spencer Moore NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPENCER MOORE (NPI 1114729340) is an individual student in an organized health care education/training program in Indianapolis, Indiana and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1114729340
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSPENCER MOORE
Location Address1701 N SENATE BLVDIndianapolis, IN 46202-1239
Mailing Address350 W 14th StIndianapolis, IN 46202-2369 · (317) 274-0267
Phone(317) 338-6399
Fax(317) 338-6359
Sole ProprietorNo
Enumeration DateMarch 26, 2025
Last NPPES UpdateJune 16, 2026
NPPES CertifiedJune 16, 2026
✔ NPI 1114729340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1701 N SENATE BLVD, Indianapolis, IN 46202
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Secondary Practice Locations 2

Location 1550 University BlvdIndianapolis, IN 46202-5149 · Phone (317) 274-0267
Location 2705 Riley Hospital Dr Rm W6130AIndianapolis, IN 46202-5109 · Phone (317) 274-0267

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Spencer Moore is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THOMAS M DONAHUE MD
Anesthesiology
1701 N SENATE BLVD
INDIANAPOLIS, IN 46202
Marion County (317) 577-4200
DR. GINA MARIE DIANTONIO SWARTZEL M.D.
Emergency Medicine
1701 N SENATE BLVD, B401
INDIANAPOLIS, IN 46202
Marion County (317) 962-5975
NASER A KAFEEL DO
Internal Medicine
1701 N SENATE BLVD
INDIANAPOLIS, IN 46202
Marion County (317) 962-8776
ZACHARY JARRETT DO
Internal Medicine (Critical Care Medicine)
1701 N SENATE BLVD
INDIANAPOLIS, IN 46202
Marion County (317) 962-5820
BARBRA A BACHMEIER NP
Nurse Practitioner (Family)
1701 N SENATE BLVD, RM AG 001
INDIANAPOLIS, IN 46202
Marion County (317) 962-3886
MARK H HOYER MD
Pediatrics (Pediatric Cardiology)
1701 N SENATE BLVD
INDIANAPOLIS, IN 46202
Marion County (317) 678-3900
SHALINI K MANCHANDA MD
Internal Medicine (Sleep Medicine)
1701 N SENATE BLVD
INDIANAPOLIS, IN 46202
Marion County (888) 484-3258
SEAN DAVID GUSSICK MD
Radiology (Diagnostic Radiology)
1701 N SENATE BLVD, RADIOLOGY DEPT
INDIANAPOLIS, IN 46202
Marion County (317) 962-5740

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Spencer Moore's NPI number?

The NPI number for Spencer Moore is 1114729340. It was assigned to this individual provider in the NPPES registry on March 26, 2025.

Where is Spencer Moore located?

Spencer Moore practices at 1701 N Senate Blvd, Indianapolis, IN 46202. The listed phone number is (317) 338-6399.

What is Spencer Moore's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Spencer Moore enrolled in Medicare?

Yes. Spencer Moore is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Spencer Moore was last updated on June 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 55 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.